Billing code 76977: Bone densityMedicare rate & RVUs
Reports an ultrasound-based bone density assessment at peripheral sites, such as the heel, when a clinician evaluates bone status using this method.
Medicare pays $7.68 for 76977 nationally in the office. Local office rates run $6.60–$9.92.
Medicare rate · 76977
Bone density
Swap in your local Medicare rate.
- Work RVUs
- 0.05
- Total RVUs
- 0.23
- Global days
- XXX
National rate · 2026
$7.68
Office setting, before claim adjustments.
See every locality for 76977 → · Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 10 sections
What 76977 covers
This service measures bone density with ultrasound at a peripheral site; the heel is a common example. It is performed in settings such as an outpatient clinic or osteoporosis screening service, with the equipment operated by clinical staff and the findings interpreted by a qualified physician or other eligible practitioner. The measurement is an ultrasound study, not a central DXA scan of the spine and hip or a peripheral DXA scan.
Report 76977 for the peripheral ultrasound examination, documenting the site measured, the technique, and the resulting findings. CMS recognizes separately priced professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment and staff portion, and reporting without either modifier represents the global service. The interpretation should be supported by a report documenting the results and clinical assessment; technical documentation should support performance of the measurement.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 76977 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$6.60 to $9.92
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $6.72 | Unavailable |
| Alaska* | $8.56 | Unavailable |
| Arizona | $7.42 | Unavailable |
| Arkansas | $6.60 | Unavailable |
| Atlanta | $7.91 | Unavailable |
| Austin | $7.92 | Unavailable |
| Bakersfield | $7.97 | Unavailable |
| Baltimore/Surr. Cntys | $8.26 | Unavailable |
| Beaumont | $7.15 | Unavailable |
| Brazoria | $7.50 | Unavailable |
| Chicago | $8.59 | Unavailable |
| Chico | $7.91 | Unavailable |
| Colorado | $7.90 | Unavailable |
| Connecticut | $8.27 | Unavailable |
| Dallas | $7.58 | Unavailable |
| Dc + Md/Va Suburbs | $8.80 | Unavailable |
| Delaware | $7.56 | Unavailable |
| Detroit | $7.95 | Unavailable |
| East St. Louis | $7.93 | Unavailable |
| El Centro | $7.92 | Unavailable |
| Fort Lauderdale | $8.29 | Unavailable |
| Fort Worth | $7.54 | Unavailable |
| Fresno | $7.91 | Unavailable |
| Galveston | $7.54 | Unavailable |
| Hanford-Corcoran | $7.91 | Unavailable |
| Hawaii, Guam | $8.13 | Unavailable |
| Houston | $7.91 | Unavailable |
| Idaho | $6.90 | Unavailable |
| Indiana | $6.95 | Unavailable |
| Iowa | $6.83 | Unavailable |
| Kansas | $6.84 | Unavailable |
| Kentucky | $7.03 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $8.50 | Unavailable |
| Madera | $7.91 | Unavailable |
| Manhattan | $9.05 | Unavailable |
| Merced | $7.91 | Unavailable |
| Metropolitan Boston | $8.71 | Unavailable |
| Metropolitan Kansas City | $7.34 | Unavailable |
| Metropolitan Philadelphia | $8.06 | Unavailable |
| Metropolitan St. Louis | $7.43 | Unavailable |
| Miami | $8.92 | Unavailable |
| Minnesota | $7.37 | Unavailable |
| Mississippi | $6.77 | Unavailable |
| Modesto | $7.91 | Unavailable |
| Montana** | $7.68 | Unavailable |
| Napa | $9.16 | Unavailable |
| Nebraska | $6.86 | Unavailable |
| Nevada** | $7.58 | Unavailable |
| New Hampshire | $7.82 | Unavailable |
| New Mexico | $7.37 | Unavailable |
| New Orleans | $7.46 | Unavailable |
| North Carolina | $7.08 | Unavailable |
| North Dakota** | $7.29 | Unavailable |
| Northern Nj | $8.69 | Unavailable |
| Nyc Suburbs/Long Island | $9.37 | Unavailable |
| Ohio | $7.22 | Unavailable |
| Oklahoma | $6.96 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $8.45 | Unavailable |
| Portland | $8.13 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $8.41 | Unavailable |
| Puerto Rico | $7.73 | Unavailable |
| Queens | $9.06 | Unavailable |
| Redding | $7.91 | Unavailable |
| Rest Of California | $7.91 | Unavailable |
| Rest Of Florida | $7.78 | Unavailable |
| Rest Of Georgia | $7.23 | Unavailable |
| Rest Of Illinois | $7.59 | Unavailable |
| Rest Of Louisiana | $7.04 | Unavailable |
| Rest Of Maine | $7.00 | Unavailable |
| Rest Of Maryland | $7.71 | Unavailable |
| Rest Of Massachusetts | $7.86 | Unavailable |
| Rest Of Michigan | $7.30 | Unavailable |
| Rest Of Missouri | $6.93 | Unavailable |
| Rest Of New Jersey | $8.31 | Unavailable |
| Rest Of New York | $7.22 | Unavailable |
| Rest Of Oregon | $7.46 | Unavailable |
| Rest Of Pennsylvania | $7.21 | Unavailable |
| Rest Of Texas | $7.34 | Unavailable |
| Rest Of Washington | $7.83 | Unavailable |
| Rhode Island | $7.82 | Unavailable |
| Riverside-San Bernardino-Ontario | $8.13 | Unavailable |
| Sacramento-Roseville-Folsom | $8.30 | Unavailable |
| Salinas | $8.27 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $8.47 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $9.67 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $9.65 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $9.92 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $9.83 | Unavailable |
| San Luis Obispo-Paso Robles | $8.14 | Unavailable |
| Santa Cruz-Watsonville | $8.56 | Unavailable |
| Santa Maria-Santa Barbara | $8.31 | Unavailable |
| Santa Rosa-Petaluma | $8.64 | Unavailable |
| Seattle (King Cnty) | $8.86 | Unavailable |
| South Carolina | $7.18 | Unavailable |
| South Dakota** | $7.24 | Unavailable |
| Southern Maine | $7.39 | Unavailable |
| Stockton | $7.91 | Unavailable |
| Suburban Chicago | $8.35 | Unavailable |
| Tennessee | $6.89 | Unavailable |
| Utah | $7.29 | Unavailable |
| Vallejo | $9.13 | Unavailable |
| Vermont | $7.30 | Unavailable |
| Virgin Islands | $7.73 | Unavailable |
| Virginia | $7.39 | Unavailable |
| Visalia | $7.91 | Unavailable |
| West Virginia | $7.27 | Unavailable |
| Wisconsin | $7.00 | Unavailable |
| Wyoming** | $7.51 | Unavailable |
| Yuba City | $7.91 | Unavailable |
76977 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$6.60
$8.92
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $8.56 | 1 |
| AL | $6.72 | 1 |
| AR | $6.60 | 1 |
| AZ | $7.42 | 1 |
| CA | $7.91–$9.92 | 29 |
| CO | $7.90 | 1 |
| CT | $8.27 | 1 |
| DC | $8.80 | 1 |
| DE | $7.56 | 1 |
| FL | $7.78–$8.92 | 3 |
| GA | $7.23–$7.91 | 2 |
| GU | $8.13 | 1 |
| HI | $8.13 | 1 |
| IA | $6.83 | 1 |
| ID | $6.90 | 1 |
| IL | $7.59–$8.59 | 4 |
| IN | $6.95 | 1 |
| KS | $6.84 | 1 |
| KY | $7.03 | 1 |
| LA | $7.04–$7.46 | 2 |
| MA | $7.86–$8.71 | 2 |
| MD | $7.71–$8.80 | 3 |
| ME | $7.00–$7.39 | 2 |
| MI | $7.30–$7.95 | 2 |
| MN | $7.37 | 1 |
| MO | $6.93–$7.43 | 3 |
| MS | $6.77 | 1 |
| MT | $7.68 | 1 |
| NC | $7.08 | 1 |
| ND | $7.29 | 1 |
| NE | $6.86 | 1 |
| NH | $7.82 | 1 |
| NJ | $8.31–$8.69 | 2 |
| NM | $7.37 | 1 |
| NV | $7.58 | 1 |
| NY | $7.22–$9.37 | 5 |
| OH | $7.22 | 1 |
| OK | $6.96 | 1 |
| OR | $7.46–$8.13 | 2 |
| PA | $7.21–$8.06 | 2 |
| PR | $7.73 | 1 |
| RI | $7.82 | 1 |
| SC | $7.18 | 1 |
| SD | $7.24 | 1 |
| TN | $6.89 | 1 |
| TX | $7.15–$7.92 | 8 |
| UT | $7.29 | 1 |
| VA | $7.39–$8.80 | 2 |
| VI | $7.73 | 1 |
| VT | $7.30 | 1 |
| WA | $7.83–$8.86 | 2 |
| WI | $7.00 | 1 |
| WV | $7.27 | 1 |
| WY | $7.51 | 1 |
How the 76977 rate is calculated
Each of 76977’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 76977
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.05Practice expense 0.16Malpractice 0.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 76977
The CMS indicators that decide how 76977 is paid alongside other services.
CMS payment indicators · 76977
Bone density
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
76977 without 26 · national office
$7.68
Bone density
76977-26 · Professional component
$2.67
Pays only the interpretation and report.
76977 compared with similar codes
Compare codes
76977 vs 77080 vs 77081 vs 77078: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 77080DXA bone density scan
- Use 77080 for central DXA assessment of the axial skeleton. Use 76977 for ultrasound bone density measurement at peripheral sites.
- 77081Bone density
- Both assess peripheral bone, but 77081 uses DXA technology while 76977 uses ultrasound.
- 77078CT bone density
- 77078 is a CT-based bone density study; 76977 is a peripheral ultrasound measurement.
76977 billing questions
How does 76977 differ from a peripheral DXA scan?
76977 is an ultrasound-based peripheral bone density study. A peripheral DXA scan uses dual-energy X-ray absorptiometry instead.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical portion, including equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports 76977?
Document the peripheral site measured, the ultrasound method, the measurement findings, and the interpreting practitioner's assessment. The technical record should support that the study was performed.
Is 76977 reported for each peripheral site?
The code covers measurement at peripheral site or sites and does not distinguish among them by code. Document the sites measured and apply the applicable unit-reporting instructions.
Is a heel ultrasound the same as a central bone density study?
No. A heel ultrasound is a peripheral study reported with 76977; central DXA evaluates the axial skeleton and is reported with a different code.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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